Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study

IF 4.7 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2025-02-01 DOI:10.1016/j.iccn.2024.103769

Bert Maertens , Stijn Blot , Diana Huis in ’t Veld , Koen Blot , Annelies Koch , Katrien Mignolet , Elise Pannier , Tom Sarens , Werner Temmerman , Walter Swinnen

{"title":"Stepwise implementation of prevention strategies and their impact on ventilator-associated pneumonia incidence: A 13-Year observational surveillance study","authors":"Bert Maertens , Stijn Blot , Diana Huis in ’t Veld , Koen Blot , Annelies Koch , Katrien Mignolet , Elise Pannier , Tom Sarens , Werner Temmerman , Walter Swinnen","doi":"10.1016/j.iccn.2024.103769","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.</div></div><div><h3>Design</h3><div>Historical observational surveillance study conducted over 13 years.</div></div><div><h3>Setting</h3><div>A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.</div></div><div><h3>Participants</h3><div>Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.</div></div><div><h3>Interventions</h3><div><span>Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, </span>chlorhexidine oral care, and daily sedation assessment.</div></div><div><h3>Measurements and main results</h3><div>A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.</div></div><div><h3>Conclusions</h3><div>Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.</div></div><div><h3>Implications for Practice</h3><div>The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"86 ","pages":"Article 103769"},"PeriodicalIF":4.7000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S096433972400154X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To describe the practice of ventilator-associated pneumonia (VAP) prevention and control through the incremental introduction of prevention strategies and assess the effect on VAP incidence.

Design

Historical observational surveillance study conducted over 13 years.

Setting

A 12-bed adult intensive care unit (ICU) in a general hospital in Belgium.

Participants

Patients admitted between 2007 and 2019, with ICU stays of ≥48 h.

Interventions

Incremental introduction of VAP preventive measures from 2008, including head-of-bed elevation, cuff pressure control, endotracheal tubes with tapered cuffs, subglottic secretion drainage, chlorhexidine oral care, and daily sedation assessment.

Measurements and main results

A significant decline in VAP incidence density rates was observed, from 18.3 to 2.6 cases per 1000 ventilator days from the baseline to the final period.

Conclusions

Systematic implementation of VAP preventive measures significantly reduced VAP incidence. However, this reduction did not translate into decreased overall ICU mortality.

Implications for Practice

The study underscores the importance of continuous VAP surveillance and preventive measures in reducing VAP incidence.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

逐步实施预防策略及其对呼吸机相关肺炎发病率的影响：一项为期 13 年的观察性监测研究。

目的描述通过逐步引入预防策略来预防和控制呼吸机相关肺炎（VAP）的做法，并评估对 VAP 发生率的影响：设计：历时 13 年的历史性观察监测研究：地点：比利时一家综合医院拥有 12 张病床的成人重症监护病房（ICU）：干预措施：干预措施：从2008年起逐步引入VAP预防措施，包括抬高床头、控制袖带压力、使用锥形袖带的气管插管、声门下分泌物引流、洗必泰口腔护理和每日镇静评估：从基线到最后阶段，VAP发病密度明显下降，从每1000个呼吸机日18.3例降至2.6例：结论：系统性地实施 VAP 预防措施大大降低了 VAP 的发生率。结论：系统性地实施 VAP 预防措施大大降低了 VAP 的发生率，但这种降低并没有转化为 ICU 整体死亡率的下降：这项研究强调了持续的 VAP 监测和预防措施对降低 VAP 发生率的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.